Senior Fraud Investigation Lead — Global Health (Hybrid)

Cigna Health and Life Insurance Company; Glasgow; Hybride; GBP 70 000 - 90 000; Plein temps

Avantages offerts par ce poste

Hybrid working model

Flexible hours

Competitive benefits

Résumé du poste

Cigna Healthcare, a division of The Cigna Group, seeks a Fraud Senior Supervisor to lead the Member Investigation Unit in detecting and recovering FWA, partnering across teams to prevent overpayments and monitor spend. You will guide the team, ensure regulatory compliance, and maintain data integrity in investigations.

Ideal candidates bring 5+ years in health insurance or international health care, a counter-fraud qualification, and strong analytics, reporting, and stakeholder management

Qualifications

• Experience leading operational teams in health insurance or international health care.
• Accredited counter fraud qualification.
• Minimum of 5 years in health insurance or international health care provider experience.
• Knowledge of claims coding, regulatory rules and medical policy.

Responsabilités

• Lead the Member Investigation Team to identify and prevent fraudulent, wasteful, and abusive expenses.
• Collaborate with PI senior management to execute department plans and priorities.
• Represent Payment Integrity when engaging with external clients and report fraud risks.
• Manage internal stakeholder relationships and ensure KPI achievement.
• Coach Investigators and ensure compliance with SOPs and data integrity.
• Oversee reporting and monitoring to track PI savings and performance.

Connaissances

Leadership experience

Fraud investigation

Regulatory compliance

Risk management

Data analytics

Communication skills

Cross-functional collaboration

Team coaching

Media/claims terminology

Outils

Data analytics tools

Description du poste

Cigna Healthcare, a division of The Cigna Group, seeks a Fraud Senior Supervisor to lead the Member Investigation Unit in detecting and recovering FWA, partnering across teams to prevent overpayments and monitor spend. You will guide the team, ensure regulatory compliance, and maintain data integrity in investigations.

Ideal candidates bring 5+ years in health insurance or international health care, a counter-fraud qualification, and strong analytics, reporting, and stakeholder management